Pastoral Medicine

Pastoral Medicine: Lecture 9

Schmidt Number: S-5936

On-line since: 27th March, 2008

LECTURE 9

Dear friends,

You have seen how necessary it is
to relate a state of illness in a human being to his
or her spiritual life and experience. The understanding that should
be brought to illness by the two groups of people who have especially
to do with pastoral medicine can really only come from such a point
of view. Therefore I would like once more to consider the actual
state of illness in connection with a person's spiritual life, this
time from a standpoint that I think will throw greatest light upon
the nature of illness.

As human beings we
alternate between waking and sleeping. You all know in general what
can be said from our perspective about these two conditions.

Today let us hold clearly
in our minds what really happens in the human being during sleep. The
physical body and etheric body are by themselves; the astral body and
ego are also by themselves. Turning first to the physical and etheric
bodies, we know that by virtue of what these bodies are, certain
processes go on that during the person's sleep are independent of the
activity of the astral body and ego. In the human organism we find
processes going on that are not at all suited to it in the way they
must play themselves out. The physical body has to do with physical
processes. Physical processes take their course outside in the
mineral kingdom; they are suited to the mineral kingdom. They are not
at all suited to the constitution of the human physical body. And yet
while it is asleep this human body is, so to speak, subject to these
physical processes in the same way that the mineral kingdom is. We
must be aware of this contradiction in the human being precisely
during sleep. During sleep the human being ought to be a world of
physically active forces and substances, but this is something that
really cannot be. That is why processes that go on in the physical
body during sleep — unless they are brought into balance
— cause illness.

The general assertion
that sleep is healthful is correct in a certain sense, but only under
certain conditions. And it must not prevent us from examining the
true situation without prejudice. Physical processes in the human
physical body can only be healthful when the ego and astral
organization are down in the physical body, as is the normal
condition during waking life. It is constantly interrupted by the
sleep condition. Normally, however, even during sleep the catabolic
process is still always going on in the physical body; it must be
there so that the soul-life and spiritual life as a whole can really
unfold. For the spiritual life is not connected with anabolic
processes, only with catabolic processes. During sleep, therefore,
there must be just as much of the catabolic processes as a person
needs for waking life to unfold the next morning. If too many
catabolic processes are there because of some unhealthy sleep
condition, a residue of these processes piles up in the human
organism, and then we have the inner cause for an illness.

If we extend our
investigation to the etheric body, we find that during sleep only the
processes can take place in the etheric body that can otherwise take
place in the plant kingdom. During daytime consciousness, when the
astral body and ego are in the etheric body, these processes are
always raised to a higher level. But from the moment of a person's
going to sleep to the moment of waking, they take their course in the
same way that they do in the plant kingdom. Thus they too are not
suited to the human organism; they need to be balanced by the astral
body and ego. If they create a residue, this too is cause for
illness. So we can say that sleep can show us how causes of illness
really originate in the human organism. For they are fundamentally
the normal sleep processes; at the same time they are the basis for
human soul-spiritual life. And that points to a secret of this world
— that whenever one penetrates to reality, one finds it has two
sides! On one side, in the sleep condition of the human physical and
etheric bodies we find the basis for spiritual development; on the
other side, in the very same processes we find the basis for
illnesses. Thereby illness is brought into direct connection with
human spiritual development. Thus if we study what is active during
sleep in the human physical and etheric bodies, we find the
fundamental causes of illness.

Now let us consider
from this point of view those who during waking life do not go down
deeply enough into their physical and etheric bodies — which is
what we have found to be the case in the mentally retarded or the
psychopath. With such people the soul and spirit enter into processes
of illness and live with them. Special value should be laid on this
knowledge, that psychopaths and the so-called mentally disturbed are
always closely involved in their inner lives with the causes of
illness. You see, one has to look at such things carefully.

But now let us go to
the outer world. Let us start from the human physical body
(Plate VI, left)
and consider the outer mineral world that relates to it. During sleep
we have processes in the human physical body from which the ego is
missing. They go on without really any inner working
“motor.” But there is ego out there in the world in all
those mineral processes. In them is what we can call world-ego. So we
have on the one hand within the processes of the human physical body
a condition of non-ego, a sum of processes that are egoless,
processes that lack ego. And we have on the other hand in our outer
environment a sum of mineral processes and mineral substances that
are permeated by ego — that means, by all the hierarchies who
are to be identified with ego. Mineral substance has ego.

Plate VIClick image for large view

[It appears Plate IV and VI were mixed up in the original publication of the book ...we have switched them (see date in lower-left of image) – e.Ed]

Therefore let us
assume that we observe in some person's physical body a process that
should not be there, a sick process. It lacks ego. What can we do if
we want to cure this condition? We can search outside in the mineral
kingdom for that part of the ego that the person lacks, to cure what
is too much asleep, to cure what is still continuing to sleep during
waking life. Then we have the right remedy. If you give the substance
that has an affinity to the sick organ, the ego-force that the organ
lacked is brought into the organ. This is the principle underlying
our search in inorganic nature around us for medicinal remedies for
the physical body of the sick person. We have to find the
corresponding substance that has ego-force; then it has a healing
effect. Thus the transition from pathology to therapy rests upon a
correct insight into the relation between the processes of the human
physical body and the outer mineral world on the one hand, and the
relation of the human etheric body to the plant world on the other.
If we observe too exuberant a growth in the etheric body, we realize
that the etheric body is lacking proper penetration by the astral
body. Then we must search in the plant kingdom for the proper
corresponding remedy. This is the direction our work must take.

One must recognize the
spirit in nature, the spirit that is in the mineral and plant
kingdoms of the world. It is the spirit, not the substance, that one
must know, because in reality one heals the human being through the
spirit that is in the mineral and in the plant. In its nature
substance is not truly governed by spirit, but even so it has spirit
in it. And those who want to heal without recognizing the spirit in
stones and plants can only grope their way through traditional
theory. They can try one thing or another and see whether it helps,
but they will never know why
it helps — because they will never know just where the spirit
is in possession of some mineral or how it is in possession of it. To
be a healer requires first and foremost a spiritual outlook on the
world. And indeed this is the greatest anomaly of our time: that it
is medicine itself that has the frightful disease of materialism.
Medicine is seriously ill with materialism. It has become blind and
is falling asleep, and this is creating harmful soul substances in
science. It really needs to be healed. One can indeed say, the
sickest entity of our time is not Turkey,
[Note 12]
as was the case in nineteenth-century Europe, but the medical profession.
This is a fact that physicians should know — as well as the
theologians, for then perhaps the secret will remain among those to
whom it has been entrusted!

Let us look at these
things more closely. There are certain persons who are not
psychopathic or insane in the sense in which one is justified in
using those terms, but who nevertheless illustrate what I have been
talking about during the last few days. They descend into their
physical and etheric bodies in such a way that they acquire a certain
perceptible connection to their sick condition, to sick processes.
These are sleepwalkers, whose peculiar state is not make-believe; it
has often been described to the general public, and every initiate
knows it well. While they are in their somnambulistic condition, they
describe their illnesses. They go down into their physical and
etheric body. Now the normal human being in waking life has the
physical and etheric bodies completely saturated by the astral body
and the ego. In the case of these sick individuals, the ego and
astral body do not combine with the etheric and physical body in
accordance (figuratively speaking) with their exact atomic weight.
Some of the ego and astral body is left out; it has not entirely sunk
down. But then it is this element that is able to perceive. Only that
part of the ego and astral body perceives that has not sunk down into
the etheric and physical body. When some of the astral body and ego
is superfluous in such a person, then there is this inner perception,
and the person can describe his or her own illness.

But now there is
another condition — a condition of the opposite kind, in which
the normal sleep condition is disturbed. In this case, when the ego
and astral body are outside the physical and etheric body and things
happen in the ego and astral body that do not belong in this
soul-spiritual entity (as the things I was just describing did not
belong in that physical-etheric body), when too much spirit is
experienced by the ego and astral body during sleep (as too much
nature was experienced in the opposite condition by the
physical-etheric body), then a clairvoyance comes about that borders
on a pathological state. The individual carries into sleep a certain
power to perceive spiritual things, then afterward carries back
memories of spiritual perception into waking consciousness. In
particular, these abnormal spiritual perceptions appear in lively
dreams. And then, as every initiate knows, we observe that the dreams
have the following content.

Suppose the sick
person, the physically sick person, is in the former condition I was
describing and dips down with the spirit and soul into the
physical-etheric body and then experiences the illness in a
somnambulistic condition. The sick person experiences a strong
catabolic process going on in the physical-etheric body, a kind of
reverse process of nature. But now suppose the person is outside the
physical body with the astral body and ego. Then the person has
experiences of the spiritual aspect of external nature. Suppose the
person experiences a sick organ inwardly — sick because it
allows some outer process to occur in an unhealthy way. This is
experienced in the somnambulistic state, and the inner process is
described. If the person is in the opposite condition, the
somnambulism works into the ego and astral body when these are
farther out of the physical and etheric body. If the spiritual,
elemental life of nature comes into dreams, the person experiences
what is spiritual in the minerals. And what does the person dream
about? The person dreams of the medicinal remedy. Here you have the
connection between many aspects of somnambulistic life. The
somnambulist alternates between two conditions, as I have described.
In one condition dreaming of the illness, in the other condition
dreaming of the remedy. And generally speaking, that is the way
pathology and therapy were explored in the old mysteries.

In those times there
was not so much experimenting as there is today. The sick person was
brought into the temple and put into a kind of somnambulistic
condition by trained temple priests. This condition was increased to
the level at which the sick person could describe the process of the
illness. Then the opposite somnambulistic condition was brought
about, and the temple priest was told the dream that contained the
therapy. This was the manner of inquiry in the oldest mysteries; it
led from disease to cure. And so it was that medical science was
cultivated in olden times, by seeking knowledge of humanity through
the human being itself.

We don't have to go
back to those old methods. We have to move forward to methods by
which we are able to follow the course of an illness through
imaginative experience, and by which we are able to experience the
healing process through an intuitive activity that leads not into the
human being, but outward. What has formerly been a kind of
experimentation in this field will now have to become careful
observation. You see the direction in which we are turning. In olden
times external physical science was a purely observing science; then
it began to experiment and more and more substituted experiment for
pure observation. That was right. But medical science did the same
thing in imitation, and that was not right. It experimented on human
beings with the temple research. We must find the way to change over
from experimenting to observing, to an observation of life that is
sustained by spiritual knowledge and enriched by scientific research.
For whoever really looks at life can catch a view of illness
everywhere. In the simplest form of everyday life that has deviated
only to the slightest degree from so-called normal, something can be
seen that will lead — if considered properly — to a
recognition of complicated disease processes. One has only to
understand how things relate to one another.

But this shows us that
physicians must more and more become really practical individuals
— again, the exact opposite of what recent materialistic
development has made them. They have gradually become pure
scientists. And that makes no sense. A physician should always be
able to cope with natural laws in a living way, and not just know
them abstractly. With abstract knowledge of them one has not yet even
begun to work with them. That's the situation from one side.

Let us look at the
other side, the side that the priest must see. We think of the
priest's mission as guiding human beings in their approach to the
spiritual world, in everything that will help their ego and astral
body to find their way in the spiritual world. If it is the
physician's task to inquire into the nature of humanity from a
spiritual point of view, to explore pathological conditions from a
spiritual point of view, then what must the priest look for? The
priest has to find what can lead human beings toward the spiritual
world; their attitude toward the spiritual world, whether they love
the spiritual world, how much they are permeated by the spiritual
world — insofar as these things are apparent in normal life.
The priest must deal with all the normal or abnormal symptoms that
the human soul manifests in this regard in everyday life. For the
priest we have to point out the opposite course to that of the
physician. We told the physician that if somnambulists are allowed to
describe their sick organ, they will also describe the medicinal
remedy for it from out of their dreams.

Let us look again at
the priests in the ancient mysteries. They were not primarily
interested in discovering medicinal remedies, although of course they
were intensely interested in healing, for they were first and
foremost a friend of humanity. But they did not stop at healing; they
were interested in more than that. They were interested in the
following: They saw that the somnambulist found his or her own remedy
in dreams while in the spiritual world with the ego and astral body.
The priests paid particular attention to this soul while it was in
the spiritual world, and followed it back again into the body. And
what was found? Of course they found themselves again confronting the
sick organ. But now, from what they had perceived of that soul while
it was out of the body, they knew how the astral body and ego would
work in this organ if it were healthy. Upon returning again to the
sick organ, they knew what the situation would be under healthy
conditions. Now they realized how the astral body and ego out of
their divine-spiritual powers take hold normally in the human
organism, how they sit normally within it. The priests learned to
know them in their healthy normality through the dreams in the
spiritual world, and learned how they relate to the physical world
when they descend into the physical body. From this, the priests
learned to know the inner relation of humanity to the spiritual
world.

This knowledge should
influence priests as they enact the sacrament in which they are
carrying back the spiritual world. For the spiritual world is present
in the sacrament through the establishment of the ritual. The ritual
unites spirit with physical substance by virtue of deep insight into
the relation of spirit to matter. Inspirited physical substance is
led back into human beings, and the relation is established in them
that unites their astral body and ego within their physical and
etheric bodies with the divine-spiritual being of the world.
Everything in this relation depends upon the priest's celebrating the
sacraments with such an attitude. Everything depends upon our
permeating ourselves with such thoughts. For instance, the relation
between experience in the body and experience out of the body;
secrets of pathology from observing the body when it is left; secrets
of therapy from observing abnormal life in the spiritual world as
compared to normal perception in the spiritual world. What was
established in ancient times in secret temple procedures by prominent
somnambulists must now be again established by human beings
developing spiritual perception in themselves and observing the
connections. In this area, experiment must give way to
observation.

Now it is important
that the physicians and priests in the anthroposophical movement are
already united in their knowledge of such facts as these. That is
what really binds us together. We are permeated by a different kind
of knowledge from what others have. By contrast, the idea that some
sort of union or association or group should be formed is just an
abstraction. What really binds us together is the possession of
certain knowledge. Those who possess this knowledge obviously belong
together, and should feel closely united to one another. Any external
association should be an expression of the inner union created by
this knowledge.

Our time suffers very
much in this respect. For instance, often when I speak today to, say,
a youth gathering, even though I fully appreciate their endeavor and
even though I myself have the very best intentions, it is
extraordinarily difficult to experience their response to the
concrete truths that should be filling their souls. It is difficult
when I hear them say, “The first thing we must do is to join
together!” Well, indeed, everything in these last decades has
been “joined together” — ad infinitum!
People have gone on and on
joining together, but they've never yet got anything real for a
result by tacking zeros onto one another indefinitely —
00000000 and so on. One empty consciousness to begin with, joined to
another empty consciousness, joined to a third consciousness, again
empty — that all adds up to nothing. By contrast, you only have
to assume a content — a content that is, after all, the basis
of all zeroes: one. Then you have something. It doesn't have to be a
human being, but it has to be some genuine content. Interestingly
enough, this assumes that there is something there to begin with. It
doesn't even have to be a human being. It can be real, living
knowledge. These are things we should think about in our time. For
usually people are much too comfortable to search for the concrete;
they are content simply to put abstractions together. Joining
together is all right, of course, but it will come of itself if
something concrete is there first.

Perhaps this is
something that should be understood before anything else by those who
work among modern humankind as physicians and priests. Today two
conditions can be observed throughout the world. Generally speaking,
our ego and astral body do not find properly our physical and etheric
bodies, whatever our waking condition may be. Also, truly, for those
observing the world as it evolves, materialistic views don't really
worry them unduly! Let the monists and the others fight with one
another. Nothing is accomplished thereby. But that is certainly not
the fundamental evil in the evolution of humanity. If one is
observing the evolutionary process, one is not particularly
interested to participate in these discussions of worldviews. For
actually, whether one thinks this or another thinks that, opinions
are frightfully thin little things in the human soul! They're just
bubbles in the reality of this world. If one bubble hits another, if
one bursts, if another becomes a bit thicker from the bursting of
another, none of it matters. What does matter, what should be clearly
realized, is that one does not ever becomes a materialist if one is
sitting with one's ego and astral body properly in the physical and
etheric bodies. In other words, to be a materialist means in a finer
sense to be ill. One must fill one's whole being with this knowledge.
And it is not surprising in the least that when others, those who are
sitting properly inside their physical and etheric bodies, encounter
the sick materialists, they turn away to exactly the opposite pole
— to all the vague mist of spiritualism.

Here we come to a
difficult area, because these things do not take place in those parts
of the world that still have a connection with one another; they
happen where the world has been thrown into chaos and its pieces lie
scattered about. One thing no longer reveals itself as a healing
remedy for another, for they are falling away from each other. So
long as sick people speak of what is going on in their organs, their
dreams will still reveal the corresponding healing remedies in the
outer world. But in our present time people who are ill from
materialism will not be describing sick inner organs; they have
broken free of their organism; they want to describe the external
world, as a materialist naturally would. Then they find not remedial
dreams but the opposite — false spiritualism, which is
certainly not a remedy. On the contrary, it brings on the illness
more strongly than ever.

And so we find today
in our time — if I may draw an analogy between medical work for
individuals and cultural pathology and therapy — we find that
spiritualism does not by any means offer a remedy for materialism,
but corresponds to the somnambulist's dream revealing his sick
organs. Now sometimes a process that properly should have taken hold
of a person's inner organism pushes through the organism to the
periphery, to the outer world; there is then the pathological
condition called a “rash.” This corresponds exactly to
what I've been telling you about. One sees with one's own eyes that
what had been inside and is now outside is nothing healthy. It is an
aberration. The physician should see clearly that materialism is a
rash and needs to be regarded as a medical problem.

This will build a
bridge to the priest's observation on the other side. The priest sees
the symptoms that rise out of sick human souls, out of their need,
out of their feelings. Spiritualism is just such a symptom. One comes
to realize that in the widest sense sick life wants to sink down into
the world, that all the disease in the present world outlook does
indeed work itself out fully — insofar as it rests on the will
— by working into people and sickening their inner life.

In the present epoch
of human evolution it is impossible to see something that could be
seen clearly in former times, because people in those days had
different characteristics. We cannot see how a false direction of the
will, a false worldview, a false view of life — all of which
were designated in olden times as sin — cause illness in the
organism. For they do not do so immediately in the ordinary way. We
are only aware of the connection in the rarest cases, cases that are
an intermediate stage between the sin and what can obviously be
diagnosed as the resulting illness. These intermediate stages may
simply develop into morbid conditions. But in this modern epoch the
sin and the real illness are so detached from each other that now
they even occur in separate incarnations. In earlier epochs they were
able to appear in close connection as cause and effect, but as
humanity developed they became separated so that sin appeared in one
incarnation, illness in a subsequent one.

Here, then, begins the
domain of the priests. Priests may no longer merely continue
traditions of olden times, speaking of sin as the cause of illness.
But if they have knowledge of repeated earth lives, they can speak of
sin from that point of view; then they will again be speaking from
the standpoint of truth. Much that priests in the world today say
about these things is no longer true; it no longer corresponds to
fact. These teachings originated in olden times, and today no one is
interested in changing the teachings to accord with what is demanded
in our time.

We have to relate
ourselves to all this. Then it will be possible to make our study of
pastoral medicine fruitful in both directions.

My intention is to
give two more lectures for this course: tomorrow, and the day after
tomorrow. I am announcing this now so that you can make your plans
accordingly.